Redentor Bacani, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

814 Issued in NV

Practice address

7000 Boulder Ave
Highland, CA 92346-3348

Phone

(909) 403-6499

NPI assigned

Nov 10, 2006

Last updated

Mar 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NV, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

State University of New York Downstate Medical Center, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Care Nevada LLCGroup PAC ID 7012137037, 106 clinicians

Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rbacani121003@westdirect.optum.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optum Medical Group II Rhodes P C

  dba Southwest Medical

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1790329407
  Medicare reassignment Care Compare group NPD
• Urgent Care Nevada, LLC

  dba CareNow Urgent Care

  • Urgent Care Clinic/Center
  • Henderson, NV
  • NPI 1134546575
  Medicare reassignment Care Compare group NPD
• Southwest Medical Associates, Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1659346005
  Medicare reassignment NPD
• Yang Medical Services, PLLC

  dba Doctoroo

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1538729322
  Medicare reassignment
• Dr. Terry D. Johnson, P.a.

  dba Forestview Primary Care

  • Family Medicine Physician
  • Moncks Corner, SC
  • NPI 1467751495
  NPD (past)
• Emergency Medicine Physicians of Clark Pediatrics McCourt, PLLC

  • Emergency Medicine Physician
  • Henderson, NV
  • NPI 1568763589
  NPD (past)
• Linda L. Johnson MD, LTD

  dba SMA Convenient Care

  • Adult Medicine Physician
  • Henderson, NV
  • NPI 1376838110
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1487725693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 BOULDER AVE",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923463348",
            "telephone_number": "909-403-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 BOULDER AVE",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923463348",
            "telephone_number": "909-403-6499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4475 S Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891197826",
            "country_code": "US",
            "telephone_number": "702-737-1880",
            "fax_number": "702-650-5729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACANI",
        "first_name": "REDENTOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "62670",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01257618",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487725693",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Asef, M.D.
• Assured Hospice
• Sheena Ataian
• Thaung Myat Aung, M.D.
• Naveh Mary Ayon
• Shahnam Nami Bahrami, M.D.
• Gavrielle Concepcion Balibay, PHARMD
• Neida Barco
• Thomas Battaile Jr., RPH
• Jenna Raelene Baumann, MA

• Medical Physician Assistant in Highland, CA
• Providers in Highland, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.